Padala et al developed a model for predicting complications in patients undergoing ablation for atrial fibrillation. This can help to identify a high risk patient who may benefit from more aggressive or an alternative management. The authors are from Virginia Commonwealth University in Richmond and Rush University in Chicago.
Patient selection: atrial fibrillation prior to catheter ablation
Parameters:
(1) cerebrovascular accident
(2) congestive heart failure
(3) coagulopathy
(4) renal failure
(5) peripheral vascular disease
(6) age in years
(7) gender
(8) COPD
(9) race
Parameter
Finding
Points
cerebrovascular accident
absent
0
present
19
congestive heart failure
absent
0
present
12
coagulopathy
absent
0
present
11
renal failure
absent
0
present
7
peripheral vascular disease
absent
0
present
6
age
< 50 years
0
>= 50 years
2
gender
male
0
female
2
COPD
absent
0
present
1
race
white
0
nonwhite
1
total score =
= SUM(points for all all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 61
• The higher the score the greater the risk of complications.
Score
Complication Rate
In Hospital Mortality
0
3.6%
0%
1 to 10
6.5%
0.2%
11 to 20
15.5%
2%
21 to 30
29.5%
4.6%
31 to 61
47.2%
6.1%
Performance:
• The area under the ROC curve was 0.65 when used to predict "any" complication.
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